What is Fuchs’ dystrophy?
Fuchs’ dystrophy, also known as Fuchs’ endothelial corneal dystrophy, is an eye condition where fluid builds up in the cornea, the eye’s clear front surface. In a healthy eye, cells lining the inside of the cornea (the corneal endothelium) maintain its fluid balance, but with Fuchs’ dystrophy, they gradually die or stop working, resulting in a fluid buildup (edema).
Fluid building up in the cornea causes it to become swollen, hazy, and less transparent, resulting in blurred vision. Tiny blisters may also form on the cornea’s surface, which can burst painfully.
Fuchs’ dystrophy usually affects both eyes, but it may worsen more quickly in one than the other.
In its early stages, the symptoms are worse when you first wake up but ease during the day. However, in its later stages, symptoms may last throughout the day.
Age is a significant risk factor for developing the condition, it typically becomes noticeable in patients age 40 or older. Other risk factors include gender, with women more likely to develop it than men, and genetics.
What are the symptoms of Fuchs’ dystrophy?
Symptoms vary between people and usually develop gradually. Common symptoms include:
- Blurred or cloudy vision: Your vision may be hazy or foggy, particularly in the morning or after a long rest. Fluid can build up during periods of rest or sleep.
- Light sensitivity: In bright light, you may see halos around lights and have difficulty seeing clearly.
- Blurred vision in low light: You may not be able to see clearly in dimly lit environments and notice worsening night vision.
- Distorted or decreased vision: You may have trouble seeing objects clearly.
- Pain or irritation: Your eyes may feel dry or as if there’s grit or sand in them.
- Difficulties with activities: You may find reading, driving, or recognizing people difficult.
How is Fuchs’ dystrophy diagnosed?
At the Assil Gaur Eye Institute (AGEI), our ophthalmologists are specialists in diagnosing corneal diseases.
The AGEI team will conduct a thorough examination before diagnosis, including:
- Medical history and symptoms: Our eye doctors will examine your medical history, including any family history of Fuchs’ or other eye diseases and your past and current eye symptoms.
- Visual acuity test: Our doctor performs a standard eye exam to test how well you can see at several distances.
- Slit-lamp examination: Using a slit lamp (a specialized microscope) we examine the structures of the eye, including the surface of the cornea, looking for signs of swelling, deposits, or irregularities.
- Specular microscopy: This non-invasive imaging technique allows our doctor to examine the corneal endothelial cells in detail, checking their density, size, and shape.
- Pachymetry: Our doctor uses this test to measure the thickness of the cornea using ultrasound.
- Endothelial cell count: This test involves our doctor using a specialized instrument to count the number of endothelial cells in the cornea.
These tests and others allow us to diagnose Fuchs’ dystrophy, another corneal dystrophy, or a corneal infection.
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What is Fuchs’ dystrophy treatment?
As Fuchs’ dystrophy is chronic and progressive, treatment options at AGEI aim to manage your symptoms and slow down the progression of the disease. Depending on the severity of your condition and symptoms, there are many treatments available, including:
- Medication: Our ophthalmologist may prescribe eye drops to relieve eye dryness, discomfort, or corneal swelling.
- Salt solution drops: Hypertonic saline drops or ointments draw out excess fluid and temporarily reduce swelling.
- Soft contact lenses: Specialized soft contact lenses can help improve your vision and provide comfort.
Surgical interventions may be necessary if your condition is severe. Our surgical treatments include:
- Descemet’s stripping endothelial keratoplasty (DSEK) or Descemet’s membrane endothelial keratoplasty (DMEK): These procedures replace damaged endothelial cells with healthy donor cells.
- Full-thickness corneal transplantation: (penetrating keratoplasty): In advanced cases with significantly impaired vision, the entire cornea is replaced with a healthy donor cornea.
- Femtosecond laser-assisted keratoplasty: This newer transplant surgery utilizes laser technology to create precise incisions during corneal transplantation, potentially improving outcomes and reducing recovery time.
Regular monitoring and follow-up visits with our eye care professionals are essential, whichever treatment you choose.
Fuchs’ dystrophy and cataracts
Although Fuchs’ dystrophy and cataracts are different eye conditions, they can coexist in some individuals. The relationship between the two is complex and varies between people, and, in some cases, Fuchs’ dystrophy can complicate cataract surgery or influence your cataract treatment. Similarly, cataract surgery may damage the endothelial cells, potentially worsening Fuchs’ dystrophy.
If you’re suffering from both conditions, our ophthalmologist will carefully evaluate your overall eye health and the effects of both conditions before recommending a treatment plan. Key elements include the severity of Fuchs’ dystrophy, the progression of cataracts, and the surgery’s potential risks and benefits.
We may recommend a combined procedure that addresses both conditions or treat your Fuchs’ dystrophy with a cornea transplant first.
Fuchs’ dystrophy and vision correction surgery
Fuchs’ dystrophy can complicate vision correction surgery, including LASIK (laser-assisted in situ keratomileusis) or PRK (photorefractive keratectomy). These procedures are primarily performed to correct refractive errors such as nearsightedness, farsightedness, and astigmatism.
Due to the corneal abnormalities associated with Fuchs’ dystrophy, vision correction surgeries that involve reshaping the cornea may pose additional risks and complications. In addition, the compromised corneal endothelial cells and the potential for corneal swelling can impact the healing process and result in less-than-optimal visual outcomes.
In some cases, we may recommend options for vision correction, such as specialized contact lenses or intraocular lenses (IOLs).
Why trust the Assil Gaur Eye Institute with your precious eyesight?
Under Dr. Assil’s leadership, AGEI has assembled a team of top ophthalmology specialists from around the country to continue our tradition of offering patients the highest quality of specialist eye care in the United States. In keeping with the founding principles of AGEI, our doctors keep their clinics comfortable and familiar, much like how family-run medical practices used to be.
Today, AGEI is nationally recognized for its compassionate, patient-centric care, commitment to pioneering advances in ophthalmology, and dedication to supporting the health and well-being of its patients and community.
Dr. Assil’s life-long commitment to advancing the field of ophthalmology is evident in his work developing new surgical techniques and advances in laser surgery. He lectures internationally and has taught state-of-the-art surgical skills to over 10,000 ophthalmologists worldwide. In addition, AGEI has participated in dozens of FDA clinical trials, either as the lead investigator or as a member of a multi-center team, testing new ophthalmological devices and surgical techniques.
Los Angeles’ leading LASIK, cataract, and retinal surgeons are available to you in one practice, with state-of-the-art treatments for all eye conditions, including glaucoma, macular disease, dry eye, and diabetic eye conditions, to name just a few.
Please call (866) 945-2745 or make an appointment online.
We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
